MEASURE #4: Overuse of Barbiturate Containing Medications for Primary Headache Disorders Headache
|
|
- Helena Dickerson
- 6 years ago
- Views:
Transcription
1 MEASURE #4: Overuse of Barbiturate Containing Medications for Primary Headache Disorders Headache Measure Description Percentage of patients age 18 years old and older with a diagnosis of primary headache who were NOT prescribed barbiturate containing medications related to the primary headache disorder diagnosis during the 12-month measurement period. Measure Components Numerator Statement Patients who were NOT prescribed barbiturate containing medications related to the primary headache disorder diagnosis* during the 12-month measurement period. *Prescribing a barbiturate containing medication for the primary headache disorders, without a justified exception, is not recommended by current evidence-based guideline recommendations. Clinicians who would have a higher score or percentage of patients that met this measure would be delivering a higher quality of care. Denominator Statement Denominator Exceptions Supporting Guideline & Other References Note: The above list of medications/drug names is based on clinical guidelines and other evidence and may not be all-inclusive or current. Physicians and other health care professionals should refer to the Food and Drug Administration s (FDA) web site page entitled Drug Safety Communications for up-to-date drug recall and alert information when prescribing medications. All patients age 18 years old and older diagnosed with a primary headache disorder*. *Primary Headache: A headache that is not caused by another disease or medical condition. For the purpose of this measure this includes the following types of headache: Migraine: Migraine without aura, migraine with aura, childhood periodic syndromes that are commonly precursors of migraine, retinal migraine, complications of migraine, probable migraine. Tension-Type Headache (TTH): Infrequent episodic TTH, frequent episodic TTH, chronic TTH, probable TTH. Cluster Headache (CH) and Other Trigeminal Autonomic Cephalgias: Cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgia form headache attacks with conjunctival injection and tearing (SUNCT), and probable trigeminal autonomic cephalgia. Other Primary Headaches: Primary stabbing headache, primary cough headache, primary exertional headache, primary headache associated with sexual activity, hypnic headache, primary thunderclap headache, hemicrania continua, and new daily-persistent headache. Exceptions: Medical exception for prescribing a barbiturate containing medications for primary headache disorder (i.e., use as a last resort for a patient who has failed all other guideline recommended medications for headache or who have contraindications; may be considered for rescue therapy in a supervised setting for acute migraine when sedation side effects will not put the patient at risk and when the risk abuse has been addressed). The following clinical recommendation statements are quoted verbatim from the referenced clinical guidelines or evidence papers and represent the evidence base for the measure: American Academy of Neurology. All Rights Reserved. 29
2 Based on concerns of overuse, medication-overuse headache, and withdrawal, the use of butalbital-containing analgesics should be limited and carefully monitored. (Grade B) 1 Don t use opioid or butalbital treatment for migraine except as a last resort. (No Level of Evidence; Choosing Wisely Recommendation) 2 Any use of barbiturates and opiates was associated with increased risk of transformed migraine after adjusting for covariates. (Not a guideline) 3 Limit and carefully monitor their use (butalbital containing agents) based on overuse, medication overuse headache, and withdrawal concerns. (Level B) 4 1 National Institute for Health and Clinical Excellence (NICE) Headaches: Diagnosis and management of headaches in young people and adults. National Clinical Guideline Centre on behalf of the National Institute for Health and Clinical Excellence (NICE) September 2012; NICE clinical guideline Lander-Gould A, Anderson W, Armstrong M et al. The American Academy of Neurology s Top Five Choosing Wisely recommendations. Neurology 2013; Published online before print February 20, 2013, doi: /WNL.0b013e31828aab14 Neurology /WNL.0b013e31828aab14 3 Bigal ME, Serano D, Buse D, et al Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study Headache. 2008; 48(8): Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology ;55(6): (Updated in 2012 by the AAN) Rationale for the Measure Gap in Care Triptans and ergots are considered first line acute treatments for migraine, not opioids or barbiturates by the US Headache Consortium Guideline. 1 However, barbiturates or butalbital containing agents are prescribed frequently. The use of barbiturates increases the risk of chronic daily headache and drug induced hyperalgesia. 2 One study noted that barbiturate or opioid class of medicine is more likely to be overused among those patients presenting to a tertiary headache center (overused substances: Butalbital containing combination products, 48%; Acetaminophen, 46.2%; Opioids, 33.3%; ASA, 32.0%; Ergotamine tartrate, 11.8%; Sumatriptan, 10.7%; Nonsteroidal anti-inflammatory medications other than ASA, 9.8%; Zolmitriptan, 4.6%; Rizatriptan, 1.9%; Naratriptan, 0.6%. Total of all triptans, 17.8%). 1 Opportunity for Improvement By reducing the use of barbiturate for primary headache disorders there is potential to decrease chronic daily headaches, improve quality of life and reduce headache associated disability. 1Matchar DB, Young WB, Rosenerg J, et al. Multispecialty consensus on diagnosis and treatment of headache: pharmacological management of acute attacks. Available at (accessed November Lipton RB, Buse DC, Serrano D et al. Examination of Unmet Treatment Needs Among Persons With Episodic Migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache Jul 23. doi: /head [Epub ahead of print] American Academy of Neurology. All Rights Reserved. 30
3 Measure Designation Measure purpose Type of measure Level of Measurement Care setting Data source Quality improvement Accountability Process Individual Practitioner Inpatient Outpatient visits Emergency Departments Urgent care Electronic health record (EHR) data Administrative Data/Claims (inpatient or outpatient claims) Administrative Data/Claims Expanded (multiple-source) Paper medical record Technical Specifications: Administrative/Claims Data Administrative claims data collection requires users to identify the eligible population (denominator) and numerator using codes recorded on claims or billing forms (electronic or paper). Users report a rate based on all patients in a given practice for whom data are available and who meet the eligible denominator criteria. The specifications listed below are those needed for performance calculation. Denominator (Eligible Population) ICD-9 and ICD-10 Diagnosis Codes: ICD-9 Code ICD-10 Code 346 Migraine G43 Migraine Migraine with aura G43.1 Migraine with aura without mention of with migraine, so stated, without mention of status G Migraine with aura, not, without status G Migraine with aura,, without status without mention of migraine G Migraine with aura, not with migraine, so stated, Migraine without aura G43.0 Migraine without aura without mention of with migraine, so stated, without mention of status without mention of migraine with migraine, so stated, Variants of migraine, not elsewhere classified without mention of G Migraine with aura, with status G Migraine without aura, not without status G Migraine without aura, without status G Migraine without aura, not G Migraine without aura, G43.9 Migraine, unspecified G Migraine, unspecified, not without status American Academy of Neurology. All Rights Reserved. 31
4 with migraine, so stated, without mention of status without mention of migraine G Migraine, unspecified, without status G Migraine, unspecified, not with migraine, so stated, Hemiplegic migraine G43.4Hemiplegic migraine without mention of G Migraine, unspecified, G Hemiplegic migraine, not without status with migraine, so stated, G Hemiplegic migraine, without mention of status without status without mention of G Hemiplegic migraine, not migraine with migraine, so stated, G Hemiplegic migraine, Menstrual migraine G43.8 Other migraine without mention of G Menstrual migraine, not without status with migraine, so stated, without mention of status without mention of migraine with migraine, so stated, Persistent migraine aura without cerebral infarction without mention of with migraine, so stated, without mention of status without mention of migraine with migraine, so stated, Persistent migraine aura with cerebral infarction without mention of with migraine, so stated, without mention of status without mention of migraine G Menstrual migraine, without status G Menstrual migraine, not G Menstrual migraine, with status G43.5 Persistent migraine aura without cerebral infarction G Persistent migraine aura without cerebral infarction, not without status G Persistent migraine aura without cerebral infarction, without status G Persistent migraine aura without cerebral infarction, not with status G Persistent migraine aura without cerebral infarction, with status G43.6 Persistent migraine aura with cerebral infarction G Persistent migraine aura with cerebral infarction, not without status G Persistent migraine aura with cerebral infarction, without status G Persistent migraine aura with cerebral infarction, not with status American Academy of Neurology. All Rights Reserved. 32
5 with migraine, so stated, G Persistent migraine aura with cerebral infarction, with status Chronic migraine without aura G43.7 Chronic migraine without aura without mention of G Chronic migraine without aura, not without status with migraine, so stated, G Chronic migraine without aura, without mention of status without status without mention of G Chronic migraine without aura, not migraine with migraine, so stated, G Chronic migraine without aura, Other forms of migraine G43.8 Other migraine without mention of G Other migraine, not without status with migraine, so stated, G Other migraine, without without mention of status status without mention of G Other migraine, not with migraine status with migraine, so stated, G Other migraine, with status Migraine unspecified G43.9 Migraine, unspecified without mention of G Migraine, unspecified, not without status with migraine, so stated, G Migraine, unspecified, without mention of status without status without mention of G Migraine, unspecified, not migraine with migraine, so stated, G Migraine, unspecified, 784 Symptoms involving head and neck Headache G44.1 Vascular headache, not elsewhere classified R51 Headache 307 Special symptoms or syndromes not elsewhere classified Pain disorders related to psychological factors Tension headache G Tension-type headache, unspecified, not 339 Other headache syndromes Cluster headaches and other trigeminal autonomic cephalgias Cluster headache syndrome, unspecified G Cluster headache syndrome, unspecified, not Episodic cluster headache G Episodic cluster headache, not Chronic cluster headache G Chronic cluster headache, not Episodic paroxysmal hemicranias G Episodic paroxysmal hemicrania, not American Academy of Neurology. All Rights Reserved. 33
6 Chronic paroxysmal hemicranias G Chronic paroxysmal hemicrania, not Short lasting unilateral neuralgiform G Short lasting unilateral neuralgiform headache with conjunctival injection and headache with conjunctival injection and tearing tearing (SUNCT), not Other trigeminal autonomic G Other trigeminal autonomic cephalgias cephalgias (TAC), not Tension type headache unspecified G Tension-type headache, unspecified, not Episodic tension type headache G Episodic tension-type headache, not Chronic tension type headache G Chronic tension-type headache, G Chronic tension-type headache, not Complicated headache syndromes Hemicrania continua G44.51 Hemicrania continua New daily persistent headache G44.52 New daily persistent headache (NDPH) Primary thunderclap headache G44.53 Primary thunderclap headache Other complicated headache G44.59 Other complicated headache syndrome syndrome Other specified headache syndromes Hypnic headache G44.81 Hypnic headache Headache associated with sexual G44.82 Headache associated with sexual activity activity Primary cough headache G44.83 Primary cough headache Primary exertional headache G44.84 Primary exertional headache Primary stabbing headache G44.85 Primary stabbing headache Other headache syndromes G44.89 Other headache syndrome AND CPT Evaluation and Management Service Codes: Outpatient: , (Office or other outpatient visit-new Patient); (Office or other outpatient visit-established Patient); (Office or Other Outpatient Consultation-New or Established Patient); Inpatient: (Initial Hospital Care); (Subsequent Hospital Care); (Hospital Discharge); (Initial Inpatient Consultation). Emergency Department: Urgent care: or American Academy of Neurology. All Rights Reserved. 34
Measure Components Numerator Statement
MEASURE #5: OVERUSE OF OPIOID CONTAINING MEDICATIONS FOR PRIMARY HEADACHE DISORDERS Headache For Quality Improvement Only. Not to be used for Public Reporting or Accountability Measure Description Percentage
More informationOveruse of barbiturate and opioid containing medications for primary headache disorders Description
Measure Title Overuse of barbiturate and opioid containing medications for primary headache disorders Description Percentage of s age 12 years and older with a diagnosis of primary headache who were prescribed
More informationMEASURE #1: MEDICATION PRESCRIBED FOR ACUTE MIGRAINE ATTACK Headache
MEASURE #1: MEDICATION PRESCRIBED FOR ACUTE MIGRAINE ATTACK Headache Measure Description Percentage of patients age 12 years and older with a diagnosis of migraine who were prescribed a guideline recommended
More information2019 COLLECTION TYPE: MIPS CLINICAL QUALITY MEASURES (CQMS) MEASURE TYPE: Patient Reported Outcome High Priority
Quality ID #435: Quality of Life Assessment For Patients With Primary Headache Disorders National Quality Strategy Domain: Effective Clinical Care Meaningful Measure Area: Patient Reported Functional Outcomes
More informationMEASURE #9: MIGRAINE OR CERVICOGENIC HEADACHE RELATED DISABILITY FUNCTIONAL STATUS Headache Quality Improvement Only
MEASURE #9: MIGRAINE OR CERVICOGENIC HEADACHE RELATED DISABILITY FUNCTIONAL STATUS Headache Quality Improvement Only Measure Description Percentage of patients age 6 years old and older who have a diagnosis
More informationMEASURE #3: PREVENTIVE MIGRAINE MEDICATION PRESCRIBED Headache
MEASURE #3: PREVENTIVE MIGRAINE MEDICATION PRESCRIBED Headache Measure Description Percentage of patients age 18 years old and older diagnosed with migraine headache whose migraine frequency is 4 migraine
More informationBy Nathan Hall Associate Editor
By Nathan Hall Associate Editor 34 Practical Neurology March 2005 These new rules may change the definition of head pain, but some practitioners may find the new guidelines themselves to be a source of
More informationIndex. Prim Care Clin Office Pract 31 (2004) Note: Page numbers of article titles are in boldface type.
Prim Care Clin Office Pract 31 (2004) 441 447 Index Note: Page numbers of article titles are in boldface type. A Abscess, brain, headache in, 388 Acetaminophen for migraine, 406 407 headache from, 369
More informationHeadache. Luke Bennetto Consultant Neurologist Engineers House 13 th September 2016
Headache Luke Bennetto Consultant Neurologist Engineers House 13 th September 2016 Contents General thoughts Primary headache Secondary headache I want to curl up in a cave and die I want to drill a
More informationChronic Daily Headaches
Chronic Daily Headaches ANWARUL HAQ, MD, MRCP(UK), FAHS DIRECTOR BAYLOR HEADACHE CENTER, DALLAS, TEXAS DISCLOSURES: None OBJECTIVES AT THE CONCLUSION OF THIS ACTIVITY, PARTICIPANTS WILL BE ABLE TO: define
More informationClassification and WHO ICD-10NA Codes
Classification and WHO ICD-10NA Codes IHS WHO Diagnosis ICHD-II ICD-10NA [and aetiological ICD-10 code for secondary headache disorders] code code 1. [G43] Migraine 1.1 [G43.0] Migraine without aura 1.2
More informationปวดศ รษะมา 5 ป ก นยาแก ปวดก ย งไม ข น นพ.พาว ฒ เมฆว ช ย โรงพยาบาลนครราชส มา
ปวดศ รษะมา 5 ป ก นยาแก ปวดก ย งไม ข น นพ.พาว ฒ เมฆว ช ย โรงพยาบาลนครราชส มา 1 CONTENT 1 2 3 Chronic Daily Headache Medical Overused Headache Management Headaches are one of the most common symptoms List
More informationA synopsis of: Diagnosis and Management of Headaches in Adults: A national clinical guideline. Scottish intercollegiate Guidelines Network SIGN
A synopsis of: Diagnosis and Management of Headaches in Adults: A national clinical guideline Scottish intercollegiate Guidelines Network SIGN November 2008. PETER FRAMPTON MSc MCOptom BAppSc (Optom)(AUS)
More informationFINANCIAL DISCLOSURE. No relevant financial relationships
Sleep and Headache Paul Mathew, MD, FAHS Director of Continuing Medical Education John R. Graham Headache Center Brigham & Women s Hospital Director of Headache Medicine Cambridge Health Alliance Harvard
More informationQuality ID #435: Quality of Life Assessment For Patients With Primary Headache Disorders National Quality Strategy Domain: Effective Clinical Care
Quality ID #435: Quality of Life Assessment For Patients With Primary Headache Disorders National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE
More informationFemale patients or caregivers counseled* at least once a year about how epilepsy and its treatment may affect contraception OR pregnancy.
MEASURE #6: Counseling for Women of Childbearing Potential with Epilepsy Measure Description All female patients of childbearing potential (12-44 years old) diagnosed with who were counseled or referred
More informationThe determination of eligible population for this measure requires administrative claims data.
Overuse of Imaging Measure 6: Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Headache Description This measure assesses the ratio
More informationDenominator Exceptions
MEASURE #5: Screening for Psychiatric or Behavioral Health Disorders Measure Description Percent of all visits for patients with a diagnosis of epilepsy where the patient was screened for psychiatric or
More informationHeadache Pain Generators
Objectives 1. Define the major categories of headache. 2. Take a history directed at characterizing a headache pattern in an individual patient and identify the cause or triggers of the headache. 3. Understand
More informationA case of a patient with chronic headache. Focus on Migraine. None related to the presentation Grants to conduct clinical trials from: Speaker bureau:
Chronic Daily Headache Bassel F. Shneker, MD, MBA Associate Professor Vice Chair, OSU Neurology The Ohio State University Wexner Medical Center Financial Disclosures None related to the presentation Grants
More informationADVANCES IN MIGRAINE MANAGEMENT
ADVANCES IN MIGRAINE MANAGEMENT Joanna Girard Katzman, M.D.MSPH Assistant Professor, Dept. of Neurology Project ECHO, Chronic Pain Program University of New Mexico Outline Migraine throughout the decades
More informationUCNS Course A Review of ICHD-3b
UCNS Course A Review of ICHD-3b Andrew D. Hershey, M.D., Ph.D., FAHS Endowed Chair and Director of Neurology Director, Cincinnati Children s Headache Center Professor of Neurology and Pediatrics University
More informationManaging Headache in Acute Medicine. Ben Lovell Consultant Physician in Acute Medicine University College London Hospital
Managing Headache in Acute Medicine Ben Lovell Consultant Physician in Acute Medicine University College London Hospital Some ED headache stats Arrive by ambulance 31% Median age 39 Worst ever headache
More informationRegulatory Status FDA approved indication: Migranal Nasal Spray is indicated for the acute treatment of migraine headaches with or without aura (1).
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.60 Subject: Migranal Nasal Spray Page: 1 of 5 Last Review Date: November 30, 2018 Migranal Nasal Spray
More informationPatient with Lots of NTERNATIONAL CLASSIFICATION. Headaches HEADACHE DISORDERS. R. Allan Purdy, MD, FRCPC,FACP
Patient with Lots of NTERNATIONAL CLASSIFICATION Headaches of R. Allan Purdy, MD, FRCPC,FACP HEADACHE DISORDERS Professor of Medicine (Neurology) Dalhousie University, Halifax, Canada 2nd edition (ICHD-II)
More informationMigraine Migraine Age Specific Prevalence in the United States. Headache International Headache Society Classification
28 Primary Care Medicine Principles and Practice 29 October 28 Professor Peter J. Goadsby Peter.Goadsby@headache.ucsf.edu Department of Neurology Headache International Headache Society Classification
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
CGRP Page 1 of 13 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: CGRP (calcitonin gene-related peptide) Prime Therapeutics will review Prior Authorization requests
More informationMeasure #412: Documentation of Signed Opioid Treatment Agreement National Quality Strategy Domain: Effective Clinical Care
Measure #412: Documentation of Signed Opioid Treatment Agreement National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY DESCRIPTION: All patients
More informationTears of Pain SUNCT and SUNA A/PROFESSOR ARUN AGGARWAL RPAH PAIN MANAGEMENT CENTRE
Tears of Pain SUNCT and SUNA A/PROFESSOR ARUN AGGARWAL RPAH PAIN MANAGEMENT CENTRE IHS Classification 1989 (updated 2004) Primary Headaches 4 categories Migraine Tension-type Cluster and other trigeminal
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
CGRP Page 1 of 8 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: CGRP (calcitonin gene-related peptide) Prime Therapeutics will review Prior Authorization requests
More informationDiagnosing headache. The clinician should approach the diagnosis of. Secondary headache. Primary headache. Blue and red flag headaches
Headache THEME Diagnosing headache BACKGROUND A systematic approach to the diagnosis of primary and secondary headache disorders requires the measurement of the frequency and the duration of headache.
More informationMeasure #412: Documentation of Signed Opioid Treatment Agreement National Quality Strategy Domain: Effective Clinical Care
Measure #412: Documentation of Signed Opioid Treatment Agreement National Quality Strategy Domain: Effective Clinical Care 2017 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Process DESCRIPTION:
More informationAn Overview of MOH. ALAN M. Rapoport, M.D. Clinical Professor of Neurology The David Geffen School of Medicine at UCLA Los Angeles, California
An Overview of MOH IHS ASIAN HA MASTERS SCHOOL MARCH 24, 2013 ALAN M. Rapoport, M.D. Clinical Professor of Neurology The David Geffen School of Medicine at UCLA Los Angeles, California President-Elect
More information2009 ICD-9 Changes for Neurology
2009 ICD-9 Changes for Neurology Index enda Agnosia (body image) (tactile) verbal 784.69 visual 784.69 developmental 315.8 secondary to organic lesion 784.69 Allergy, allergic (reaction) 995.3 migraine
More informationI have no financial relationships to disclose. I will not discuss investigational use of medication in my presentation.
I have no financial relationships to disclose. I will not discuss investigational use of medication in my presentation. In 1962, Bille published landmark epidemiologic survey of headache among 9,000 school
More informationMigranal Nasal Spray. Migranal Nasal Spray (dihydroergotamine) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.60 Subject: Migranal Nasal Spray Page: 1 of 5 Last Review Date: June 22, 2017 Migranal Nasal Spray
More informationDisclosures. Objectives 6/2/2017
Classification: Migraine and Trigeminal Autonomic Cephalalgias Lauren Doyle Strauss, DO, FAHS Assistant Professor, Child Neurology Assistant Director, Child Neurology Residency @StraussHeadache No disclosures
More informationHeadache Master School Japan-Osaka 2016 II. Management of refractory headaches Case Presentation 2. SUNCT/SUNA: concept, management and prognosis
Headache Master School Japan-Osaka 2016 II. Management of refractory headaches Case Presentation 2. SUNCT/SUNA: concept, management and prognosis Noboru Imai(Department of Neurology, Japanese Red Cross
More informationHeadache. Section 1. Migraine headache. Clinical presentation
Section 1 Headache Migraine headache 1 Clinical presentation It is important to recognize just how significant a problem migraine headache is. It has been estimated that migraine affects 11% of the United
More informationMeasure #6: ALS Noninvasive Ventilation Treatment for Respiratory Insufficiency Discussed Amyotrophic Lateral Sclerosis
Measure #6: ALS Noninvasive Ventilation Treatment for Respiratory Insufficiency Discussed Amyotrophic Lateral Sclerosis Measure Description Percentage of patients diagnosed with ALS and respiratory insufficiency
More informationGENERAL APPROACH AND CLASSIFICATION OF HEADACHES
GENERAL APPROACH AND CLASSIFICATION OF HEADACHES CLASSIFICATION Headache is one of the most common medical complaints. Most of the population will have experienced headache, and over 5% will seek medical
More informationAll visits for patients with diagnosis of epilepsy. Denominator Statement Denominator Exceptions
Measure 2: Etiology, Seizure Type, or Epilepsy Syndrome Measure Description Percent of all visits for patients with a diagnosis of with seizure type and etiology or syndrome documented OR testing* ordered
More informationNothing to disclose 3
Nothing to disclose 3 PREVALENCE AND BURDEN OF HEADACHE Patient with CDH IHS migraine Recurrent severe headache Severe headache Episodic headache Have had headache Entire population CDH=chronic daily headache.
More informationManagement of headache
Management of headache TJ Steiner Imperial College London Based on European principles of management of common headache disorders TJ Steiner, K Paemeleire, R Jensen, D Valade, L Savi, MJA Lainez, H-C Diener,
More informationMigraine Controversies in Women s Health. Professor Peter J. Goadsby 5 December Department of Neurology
Migraine 2008 Controversies in Women s Health 5 December 2008 Professor Peter J. Goadsby Peter.Goadsby@headache.ucsf.edu Department of Neurology Headache International Headache Society Classification Primary
More informationZomig. Zomig / Zomig-ZMT (zolmitriptan) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.22 Subject: Zomig Page: 1 of 5 Last Review Date: November 30, 2018 Zomig Description Zomig / Zomig-ZMT
More informationChronic cluster headaches icd 10
Chronic cluster headaches icd 10 Search ICD - 10 -CM Diagnosis Code G44.029. Chronic cluster headache, not intractable. 2016 2017 2018 Billable/Specific Code. Applicable To. Chronic cluster headache NOS;
More informationZomig. Zomig / Zomig-ZMT (zolmitriptan) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.22 Subject: Zomig Page: 1 of 5 Last Review Date: March 16, 2018 Zomig Description Zomig / Zomig-ZMT
More informationPHARMACY COVERAGE GUIDELINES ORIGINAL EFFECTIVE DATE: 5/18/17 SECTION: DRUGS LAST REVIEW DATE: 5/17/18 LAST CRITERIA REVISION DATE: ARCHIVE DATE:
ALLZITAL (butalbital and acetaminophen) 25 mg/325 mg oral tablet Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific
More informationAdult with headache. Problem-specific video guides to diagnosing patients and helping them with management and prevention
Adult with headache Problem-specific video guides to diagnosing patients and helping them with management and prevention London Strategic Clinical Networks London Neuroscience Strategic Clinical Network
More informationClassification of headaches
Classification of headaches Jasna Zidverc Trajković Headache center Headache in adults: 1-year prevalence 13.4 Kryst 35.9 Miranda 28.7 Jaillard 87.3 O Brien 63.1 Wiehe 37.3 Lavados 59.7 Schwartz 76.0 Boardman
More informationReviews/Evaluations. Medication-Overuse Headache
Reviews/Evaluations Medication-Overuse Headache Population-based studies suggest that the prevalence of chronic daily headache is 3-5%(1,2). Drug-induced headaches are the most common cause of chronic
More informationCan I send this headache patient home? Dr Nicola Giffin Consultant Neurologist Bath, Nov 2017
Can I send this headache patient home? Dr Nicola Giffin Consultant Neurologist Bath, Nov 2017 SAH v benign thunderclap headaches Other pathologies not apparent on CT Severe primary headaches: management
More informationSumatriptan Injection (Imitrex / Alsuma / Sumavel / Zembrace)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.11 Subject: Sumatriptan Injection Page: 1 of 6 Last Review Date: March 16, 2018 Sumatriptan Injection
More informationMIGRAINE ASSOCIATION OF IRELAND
MIGRAINE ASSOCIATION OF IRELAND HEADACHE IN MEN: THE FACTS This leaflet was composed by Paolo Rossi M.D., Ph.D. of the European Headache Alliance to mark European Migraine Day of Action 2014. Why a leaflet
More informationAPPENDIX: Figure A1. Three Common Symptoms Associated with High Diagnostic Uncertainty
APPENDIX: Figure A1. Three Common Symptoms Associated with High Diagnostic Uncertainty Table A1. Survey questions used to construct the malpractice concern index Table A2. Adjusted Percentage Of Items
More informationSumatriptan Tablets, Nasal Spray (Imitrex), Nasal Powder (Onzetra Xsail), sumatriptan and naproxen sodium (Treximet tablets)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 0 Subject: Sumatriptan Page: 1 of 6 Last Review Date: November 30, 2018 Sumatriptan Description Sumatriptan
More informationAdult & Pediatric Patients. Stanford Health Care, Division Pain Medicine
Acute Treatment Strategies in Adult & Pediatric Patients Theresa Mallick Searle, MS, RN BC, ANP BC Disclosures Speakers Bureau: Allergan, Depomed Acute Treatment Strategies in Adult & Pediatric Patients
More informationIshaq Abu Arafeh Consultant Paediatrician Royal Hospital for Children, Glasgow Forth Valley Royal Hospital, Larbert
Ishaq Abu Arafeh Consultant Paediatrician Royal Hospital for Children, Glasgow Forth Valley Royal Hospital, Larbert Childhood headache: Is it really difficult to manage? It shouldn t be... But it can be...
More informationUpdate on Diagnosis and Management of Migraines
Update on Diagnosis and Management of Migraines Joel J. Heidelbaugh, MD, FAAFP, FACG Clinical Professor Departments of Family Medicine and Urology University of Michigan Learning Objectives To distinguish
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Efficiency
Quality ID #419: Overuse Of Neuroimaging For Patients With Primary Headache And A Normal Neurological Examination National Quality Strategy Domain: Efficiency and Cost Reduction 2018 OPTIONS FOR INDIVIDUAL
More informationCase Presentation. Case Presentation. Case Presentation. Truths about Headaches (2017) Most headaches were muscle-tension headaches
Agenda Case presentation Migraine Morphology Primary and Premonitory Phase Secondary Headache Aura Headache Primer on Pain Medication Overuse Headache Case Presentation RT is a 25 year old woman with daily
More informationSumatriptan Tablets, Nasal Spray (Imitrex), Nasal Powder (Onzetra Xsail), sumatriptan and naproxen sodium (Treximet tablets)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 05.70.10 Subject: Sumatriptan Page: 1 of 6 Last Review Date: March 16, 2018 Sumatriptan Description Sumatriptan
More informationClinical case. Clinical case 3/15/2018 OVERVIEW. Refractory headaches and update on novel treatment. Refractory headache.
OVERVIEW Refractory headaches and update on novel treatment Definition of refractory headache Treatment approach Medications Neuromodulation In the pipeline Juliette Preston, MD OHSU Headache Center Refractory
More informationHeadaches in Children and Adolescents. Paul Shillito
Headaches in Children and Adolescents Paul Shillito Topics For Discussion What s different about childhood migraine Chronic daily headache (CDH) Tumours and other things to worry about Management of childhood
More informationMaxalt. Maxalt / Maxalt-MLT (rizatriptan) Description. Section: Prescription Drugs Effective Date: April 1, 2016
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: Maxalt Page: 1 of 5 Last Review Date: March 18, 2016 Maxalt Description Maxalt / Maxalt-MLT (rizatriptan)
More informationMeasure #408: Opioid Therapy Follow-up Evaluation National Quality Strategy Domain: Effective Clinical Care
Measure #408: Opioid Therapy Follow-up Evaluation National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY DESCRIPTION: All patients 18 and older
More informationSUMAVEL DOSEPRO (sumatriptan succinate) solution for injection
SUMAVEL DOSEPRO (sumatriptan succinate) solution for injection Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit
More informationAll patients with a diagnosis of treatment resistant (intractable) epilepsy.* Denominator Statement
MEASURE #7 Referral to Comprehensive Epilepsy Center Measure Description Percent of all patients with a diagnosis of treatment resistant (intractable) epilepsy who were referred for consultation to a comprehensive
More informationPatient is unable to communicate and caregiver/informant is unavailable to provide information. Risk
Falls Outcome for Patients with Parkinson s Disease Measure Description Percentage of patients with PD who experienced a fall in the preceding six months. Note: A lower score is desirable. Measure Components
More informationFaculty Disclosures. Learning Objectives. Acute Treatment Strategies
WWW.AMERICANHEADACHESOCIETY.ORG Acute Treatment Strategies Content developed by: Lawrence C. Newman, MD, FAHS Donna Gutterman, PharmD Faculty Disclosures LAWRENCE C. NEWMAN, MD, FAHS Dr. Newman has received
More informationHEADACHE: Benign or Severe Dr Gobinda Chandra Roy
HEADACHE: Benign or Severe Dr Gobinda Chandra Roy Associate Professor, Department of Medicine, Shaheed Suhrawardy Medical College and Hospital Outlines 1. Introduction 2. Classification of headache 3.
More informationSumatriptan Injection (Imitrex / Alsuma / Sumavel / Zembrace)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.70.11 Subject: Sumatriptan Injection Page: 1 of 6 Last Review Date: March 17, 2017 Sumatriptan Injection
More information10/31/2017 PRIMARY CARE AND HEADACHE DISCLOSURES WHERE DO THOSE WITH HEADACHE SEEK MEDICAL CARE? Primary Care 67%
PRIMARY CARE AND HEADACHE Sonja Potrebic MD PhD Regional Headache Specialist Kaiser LAMC 1 WHERE DO THOSE WITH HEADACHE SEEK MEDICAL CARE? Column1 Primary Care 67% Primary Care Headache Specialty Other
More informationORIGINAL INVESTIGATION. Headache Evaluation and Treatment by Primary Care Physicians in an Emergency Department in the Era of Triptans
Headache Evaluation and Treatment by Primary Care Physicians in an Emergency Department in the Era of Triptans Morris Maizels, MD ORIGINAL INVESTIGATION Background: Despite advances in treatment, patients
More informationChiropractic Code Set Chiropractor (150) Effective July 2003 Last Updated July 1, 2014
Chiropractic Code Set Chiropractor (150) Effective July 2003 Last Updated July 1, 2014 1. Tables 1 through 4 identify the procedure codes that should be billed to the Indiana Health Coverage Programs (IHCP)
More informationHeadaches in the Pediatric Emergency Dept
Headaches in Children February 23, 2011 Jinny Tavee, MD Associate Professor Neuromuscular Center Cleveland Clinic Foundation Cleveland, OH 1 Headaches in the Pediatric Emergency Dept Burton Gutierrez Kan
More informationOH, MY ACHING HEAD! I HAVE NO DISCLOSURES OR CONFLICTS OF INTERESTS TO DECLARE MANAGING HEADACHE IN THE OUTPATIENT SETTING SECONDARY HEADACHES
1 JUSTIN A. OSSMAN, MD CHATTANOOGA FAMILY MEDICINE UPDATE OH, MY ACHING HEAD! MANAGING HEADACHE IN THE OUTPATIENT SETTING 2 I HAVE NO DISCLOSURES OR CONFLICTS OF INTERESTS TO DECLARE OBJECTIVES International
More informationAnti-Migraine Agents
DRUG POLICY BENEFIT APPLICATION Anti-Migraine Agents Benefit determinations are based on the applicable contract language in effect at the time the services were rendered. Exclusions, limitations or exceptions
More informationOutpatient Headache Care Guideline
1 Outpatient Care Guideline Inclusion criteria: children > 3 yrs with headaches Is urgent emergency department, neuroimaging, or Neurology consultation indicated? Referral to ED if: New severe headache
More informationPage: 1 of 5. Sumatriptan Tablets and Nasal Spray (Imitrex) / sumatriptan and naproxen sodium (Treximet tablets)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 0 Subject: Sumatriptan (Imitrex / Treximet) Page: 1 of 5 Last Review Date: September 12, 2014 Sumatriptan
More informationTriptans Quantity Limit Program Summary
Triptans Quantity Limit Program Summary FDA APPROVED INDICATIONS AND DOSAGE 1-13,14,23,24 Agents Amerge (naratriptan) 1, 2.5 tablets Axert (almotriptan) 6.25, 12.5 tablets migraine attacks with/without
More informationChronic Migraine in Primary Care. December 11 th, 2017 Werner J. Becker University of Calgary
Chronic Migraine in Primary Care December 11 th, 2017 Werner J. Becker University of Calgary Disclosures Faculty: Werner J. Becker Relationships with commercial interests: Grants/Research Support: Clinical
More informationAcute Migraine Treatment: What you and your family should know to help you make the best choices with your doctor
Acute Migraine Treatment: What you and your family should know to help you make the best choices with your doctor TAKE CONTROL OF YOUR MIGRAINES! ABOUT THIS PATIENT GUIDE: Migraine attacks are often debilitating
More informationChapter 2 Diagnosis of Trigeminal Autonomic Cephalalgias
Chapter 2 Diagnosis of Trigeminal Autonomic Cephalalgias Mark J. Stillman Introduction The trigeminal autonomic cephalalgias (TACs) refer to a specific group of primary headaches characterized by unilaterality,
More informationPREVALENCE BY HEADACHE TYPE
CLINICAL CLUES AND CLINICAL RULES: PRIMARY VS SECONDARY HEADACHE * Based on a presentation by David W. Dodick, MD ABSTRACT Headache is a common condition, accounting for many specialist office visits annually.
More informationGoals. Primary Headache Syndromes. One-Year Prevalence of Common Headache Disorders
Goals One-Year Prevalence of Common Headache Disorders Impact of primary headache syndromes Non pharmacologic Rx of migraine individualized to patient triggers Complementary and alternative Rx of migraine
More informationA new questionnaire for assessment of adverse events associated with triptans: methods of assessment influence the results. Preliminary results
J Headache Pain (2004) 5:S112 S116 DOI 10.1007/s10194-004-0123-4 Michele Feleppa Fred D. Sheftell Luciana Ciannella Amedeo D Alessio Giancarlo Apice Nino N. Capobianco Donato M.T. Saracino Walter Di Iorio
More informationTrigeminal Neuralgia Future directions. Prof Joanna M. Zakrzewska 18 th International Leksell Gamma Knife Society Amsterdam 2016
Trigeminal Neuralgia Future directions Prof Joanna M. Zakrzewska 18 th International Leksell Gamma Knife Society Amsterdam 2016 Aims and Objectives objectives Phenotying Outcomes Drugs vs surgery Imaging
More informationDisclosures. Triptans for Kids 5/16/13
5/16/13 Disclosures Triptans for Kids Amy A. Gelfand, MD GelfandA@neuropeds.ucsf.edu Departments of Neurology and Pediatrics UCSF Child Neurology and Headache Center I receive grant funding from: NIH/NINDS
More information10/19/12. Headache: Tips and Tools for Management. Michael A. Rogawski, MD, PhD Disclosures
10/19/12 Headache: Tips and Tools for Management Michael A. Rogawski, MD, PhD University of California, Davis Sacramento, CA Michael A. Rogawski, MD, PhD Disclosures Grants: Congressionally Directed Medical
More informationQuality ID #414: Evaluation or Interview for Risk of Opioid Misuse National Quality Strategy Domain: Effective Clinical Care
Quality ID #414: Evaluation or Interview for Risk of Opioid Misuse National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Process DESCRIPTION:
More informationHeadache. Susan Hickenbottom MD, MS February 24, 2015
Headache Susan Hickenbottom MD, MS February 24, 2015 Epidemiology One of most common complaints in primary care 90% of US population 50% at least one severe 25% recurrent disabling attacks 5% chronic daily
More informationHow to remove the headache of dealing with headaches. Dr. Stefan Schumacher Consultant Neurologist Salford Royal Hospital
How to remove the headache of dealing with headaches Dr. Stefan Schumacher Consultant Neurologist Salford Royal Hospital Case 30 y old woman Sudden headache Vomiting, dizziness, photophobia Recurrent migraines
More informationDo Not Cite. For Public Comment Period DRAFT MEASURE #3: Evaluation of Pulmonary Status Ordered MUSCULAR DYSTROPHY
MEASURE #3: Evaluation of Pulmonary Status Ordered MUSCULAR DYSTROPHY Measure Description All patients diagnosed with a muscular dystrophy who had a pulmonary status evaluation* ordered. Measure Components
More informationMEASURE #10: PLAN OF CARE FOR MIGRAINE OR CERVICOGENIC HEADACHE DEVELOPED OR REVIEWED Headache
MEASURE #10: PLAN OF CARE FOR MIGRAINE OR CERVICOGENIC HEADACHE DEVELOPED OR REVIEWED Headache Measure Descriptin All patients diagnsed with migraine headache r cervicgenic headache wh had a headache management
More informationSection la. Migraine and other headache syndromes. Migraine. Other headache syndromes G44
Section la Migraine and other headache syndromes Overview of categories dealing with migraine, other headache syndromes, and neuralgia of cranial nerves, in accordance with the ICD-NA, second edition G43
More informationTrigeminal Autonomic Cephalalgias. Disclosures. Objectives 6/20/2018. Rashmi Halker Singh, MD FAHS UCNS Review Course June 2018
Trigeminal Autonomic Cephalalgias Rashmi Halker Singh, MD FAHS UCNS Review Course June 2018 Disclosures Honoraria from Allergan and Amgen for advisory board, Current Neurology and Neuroscience Reports
More informationApplication of ICHD 2nd edition criteria for primary headaches with the aid of a computerised, structured medical record for the specialist
J Headache Pain (2005) 6:205 210 DOI 10.1007/s10194-005-0186-x ICHD-II: EVALUATION AND PROPOSALS Paola Sarchielli Mauro Pedini Andrea Alberti Cristiana Rossi Antonio Baldi Ilenia Corbelli Paolo Calabresi
More informationPrevention and Treatment of Migraines CAITLIN BARNES, PHARM.D. CANDIDATE AMBULATORY CARE JOE CAMMILLERI, PHARM.D. NATOHYA MALLORY, PHARM.D.
Prevention and Treatment of Migraines CAITLIN BARNES, PHARM.D. CANDIDATE AMBULATORY CARE JOE CAMMILLERI, PHARM.D. NATOHYA MALLORY, PHARM.D. Objectives Present patient case Review epidemiology/pathophysiology
More information